<?php

/*

   Aiesec's Alumni System - to manage data about Aiesec's Alumni and
   optimize the knowledge exchange between old and new members.
   Copyright (C) 2009 Vinicius Stein Dani

   This program is free software; you can redistribute it and/or
   modify it under the terms of the GNU General Public License
   as published by the Free Software Foundation; either version 2
   of the License, or (at your option) any later version.

   This program is distributed in the hope that it will be useful,
   but WITHOUT ANY WARRANTY; without even the implied warranty of
   MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
   GNU General Public License for more details.

   You should have received a copy of the GNU General Public License
   along with this program; if not, write to the Free Software
   Foundation, Inc., 51 Franklin Street, Fifth Floor, Boston, MA  02110-1301, USA.

*/

/*
  
   Author: Vinicius Stein Dani
   Contact: viniciussdani@gmail.com
   Today is: May 25, 2009
   Location at this present moment: Santa Maria - RS - Brasil
  
*/

?>

  <form action="fale_conosco_confirma.php" method="POST">
    <table border="0" cellpadding="0" cellspacing="0">
      <tr>
        <td>
        
          <table border="0" cellpadding="0" cellspacing="5">
            <tr>
              <td><div style="font-size: 18px;">Fale Conosco</div>
              </td>
            </tr>
                                      
            <tr>
              <td width="80" align="left">
                <div class="texto_noticia_descricao">Nome</div> 
                <input type="text" name="nome" style="width: 300px;" />
              </td>
            </tr>
            
            <tr>
              <td align="left">
                <div class="texto_noticia_descricao">Cidade</div> 
                <input type="text" name="cidade" style="width: 300px;" />
              </td>
            </tr>
                                   
            <tr>
              <td align="left">
                <div class="texto_noticia_descricao">E-mail</div> 
                <input type="text" name="email" style="width: 300px;" />
              </td>
            </tr>
            
            <tr>
              <td align="left">
                <div class="texto_noticia_descricao">Telefone</div> 
                <input type="text" name="telefone" style="width: 300px;" 
                onkeypress="this.value=aplicaMascara('(##) #### ####', this.value)" 
                onkeyup="this.value=aplicaMascara('(##) #### ####', this.value)" />
              </td>
            </tr>
            
            <tr>
              <td align="left" valign="top">
                <div class="texto_noticia_descricao">Mensagem</div> 
                <textarea name="mensagem" style="width: 300px; height: 62px;"></textarea>
              </td>
            </tr>
            
            <tr>
              <td align="left">
                <input type="submit" name="submit" value="Enviar" 
                style="background-color: #000000; font-family: verdana, arial, tahoma; font-size: 10px; color: #FFFFFF; height: 20px; border: 0px;" />
                
                <input type="reset" name="reset" value="Limpar" 
                style="background-color: #000000; font-family: verdana, arial, tahoma; font-size: 10px; color: #FFFFFF; height: 20px; border: 0px;" />
              </td>
            </tr>                                                                                              
          </table>
          
        </td>
        
        <td valign="top">
          <table  style="margin-top: 44px; border: 1px solid #D09668; height: 217px; width: 459px;" cellpadding="5" cellspacing="0">
            <tr>
              <td>              

                <iframe width="449" height="207" frameborder="0" scrolling="no" marginheight="0" marginwidth="0" src="http://maps.google.com.br/maps?f=d&amp;saddr=&amp;daddr=-29.71219,-53.71645&amp;hl=pt-BR&amp;geocode=&amp;mra=mi&amp;mrsp=0&amp;sz=17&amp;sll=-29.712171,-53.71645&amp;sspn=0.007175,0.009613&amp;ie=UTF8&amp;t=k&amp;ll=-29.712171,-53.71645&amp;spn=0.007175,0.009613&amp;output=embed&amp;s=AARTsJrYuiPOzQgj8NBjRLrWo1Ku9B67iQ&z=17">
                </iframe>
              
              </td>
            </tr>
          </table>          
        </td>
      </tr>
    </table>
  </form>
